Buy Insurance Step 3 – Tpllife

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Buy Insurance Step 3demo.deadhappy2023-01-17T12:24:59+00:00

Questions

Do you intake Tobacco or Nicotine in any form?
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First Name

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Last Name

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Date

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Age

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Gender

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Mobile Number

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Email

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Current Height (cm)(Required)

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Current Weight (kg)(Required)

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Occupation(Required)

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Monthly Income (PKR)(Required)

Do you intake Tobacco or Nicotine in any form?

Help us identify your consumption pattern

Do you intake Tobacco or Nicotine in any form? Yes or no

Yes

No

Do you intake Tobacco or Nicotine in any form?

Help us identify your consumption pattern

Do you intake Tobacco or Nicotine in any form?

0-5 times

5 to 10 times

10 to 20 times

Can't specify

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